Abstract

Background

Psychological distress is more prevalent and severe among patients with coronary artery disease (CAD) compared to healthy individuals. Little is known regarding its time course, and whether these differences extend to individuals with non-cardiovascular (CV) illnesses. This study examined the presence, severity, and time course of psychological distress in men and women with CAD and those of similarly aged individuals suffering from non-CV conditions.

Methods

1229 individuals (61% men; mean_age = 60.4 ± 7.0 years) with stable CAD or non-CV illnesses reported on social support, hostility, stress, anxiety and depression at baseline as well as 4.8 ± 0.8 years later. Analyses involved mixed (Sex*CAD status*Time) repeated measures analyses (controlling for relevant covariates), as well as Chi-square and McNemar analyses.

Results

Women with CAD reported more symptoms of depression compared to other participants at both evaluations (p’s < 0.01), and reported more symptoms of anxiety and stress compared to others at T1 (p’s < 0.05). At T2, perceived stress remained significantly greater among women with CAD compared to men (p’s < 0.01), though differences in anxiety were no longer significant. Men reported more hostility than women (p = 0.001). CAD women fell within the clinical range for depression (p < 0.001), anxiety (p = 0.001), and stress (p = 0.030) more frequently compared to others at T1, and for depression (p = 0.009) and stress (p = 0.002) at T2.

Conclusions

The evolution of patient distress differed as a function of the measure examined, their sex, and/or CV status. While psychological distress was prevalent among these patients with diverse health conditions, women with CAD were particularly and chronically vulnerable.

中文翻译：

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五年内心理困扰的严重程度因性别和冠状动脉疾病的存在而异

摘要

背景

与健康个体相比，冠状动脉疾病 (CAD) 患者的心理困扰更为普遍和严重。关于其时间进程以及这些差异是否延伸到患有非心血管（CV）疾病的个体知之甚少。这项研究检查了患有 CAD 的男性和女性以及患有非心血管疾病的同龄个体的心理困扰的存在、严重程度和时间进程。

方法

1229 名个体（61% 男性；平均_年龄= 60.4 ± 7.0 岁）在基线和 4.8 ± 0.8 年后报告了社会支持、敌意、压力、焦虑和抑郁的稳定 CAD 或非心血管疾病。分析涉及混合（性别*CAD 状态*时间）重复测量分析（控制相关协变量）以及卡方和 McNemar 分析。

结果

在两项评估中，患有 CAD 的女性与其他参与者相比报告了更多的抑郁症状（p < 0.01），并且在 T1 时与其他参与者相比，报告了更多的焦虑和压力症状（p <  0.05）。在 T2 时，与男性相比，患有 CAD 的女性的感知压力仍然明显更大（p < 0.01），尽管焦虑的差异不再显着。男性比女性报告了更多的敌意（p  = 0.001）。在 T1 时，与其他人相比， CAD 女性在抑郁症 ( p  < 0.001)、焦虑症 ( p  = 0.001) 和压力 ( p  = 0.030) 以及抑郁症 ( p  = 0.009) 和压力 ( p  = 0.002) 在 T2。

结论

患者痛苦的演变因所检查的测量值、性别和/或 CV 状态而异。虽然这些患有不同健康状况的患者普遍存在心理困扰，但患有 CAD 的女性尤其容易受到长期影响。